Mucosal neuroendocrine cell abnormalities in patients with chronic constipation

Area of Science:

• Gastroenterology
• Neuroendocrinology
• Histopathology

Background:

• Chronic constipation (CC) is a prevalent gastrointestinal disorder with complex pathophysiology.
• Neuroendocrine cells (NEC) play a role in regulating gastrointestinal function.
• Understanding the distribution of NEC in CC is crucial for elucidating disease mechanisms.

Purpose of the Study:

• To investigate the distribution and density of NEC in rectal biopsies of patients with chronic constipation.
• To explore potential correlations between NEC distribution, clinical presentation, and histopathological findings in CC.
• To establish a relationship between NEC pathology, symptomatology, and treatment outcomes in CC.

Main Methods:

• Rectal biopsy specimens were obtained from 43 CC patients and 20 healthy controls.
• Histopathological and immunohistochemical analyses were performed using antibodies against chromogranin-A (Ch-A) and serotonin (5-HT).
• The ratio of NEC per 70 crypts (NEC/CR) was quantified and compared between groups.

Main Results:

• Control subjects had NEC/CR ratios of 0.94 (Ch-A) and 0.32 (5-HT).
• CC patients showed significantly increased NEC/CR ratios: 2.23 (Ch-A) and 1.02 (5-HT) in conservatively managed patients, and higher levels in those with normal histology or intestinal neuronal dysplasia (IND).
• Patients with IND exhibited the highest NEC/CR ratios, indicating a strong association.

Conclusions:

• Elevated NEC numbers are associated with abnormal bowel function in chronic constipation.
• Increased NEC may be implicated in the development of giant submucosal ganglia observed in IND.
• These findings highlight the potential role of NEC in the pathogenesis of CC and associated neuropathological changes.